Evidence Based Decision Making Essay

Evidence based practice is an integral part of nursing care. According to the Academy of Medical-Surgical Nurses, evidence based practice is defined as, “the conscientious use of current best evidence in making decisions about patient care.” (AMSN) The use of evidence based practice has drastically improved patient outcomes, increased quality and safety of healthcare, and reduced costs for facilities. (Melnyk, 2016) In this paper I will provide the history of evidence based practice, how it has already been incorporated and impacted healthcare, and why it is important to nursing and healthcare as a whole.

Evidence-based practice is extremely important in health care. It is not only important to know how to perform a certain skill, but why it should be done. There needs to be a standard of care and providers need to know the best way of doing things based on evidence. The article mentions that in the 20th century, many medial decisions were made on doctor assessment and preference (Brower, 2017). Many physicians were practicing dramatically different when compared with one another, which led to the realization that changes needed to be made and Evidence-based practice began to develop. Even though Evidence-based practices have been in play for a while, there is a gap between understanding and applying evidence-based

The decision-making process occurs at all levels of management. However, the top executive managers, middle level managers, and front line managers are responsible for guiding the decision making process within their healthcare organizations (Liebler & McConnell, 2008,p.148). CEO’s are responsible for guiding the actions and behaviors of their employees to collectively achieve the organization’s goals. The mission and vision statement are the foundation of what direction the healthcare agency is heading. The CEO and top level executives are responsible for developing code of ethics and code of conduct to align with accreditation, licensing, and federal and state laws.

Sam is a recently graduated health professional and has observed that clinical practices vary in the different health care facilities. Sam is confused about which practice is the most effective to give patients better health outcomes according to the latest research literature.

When considering a change in practice we need to firstly understand why we need to make a change? Secondly when making a change, we need to justify a decision. This can be achieved by exploring the components which encompass decision making within nursing practice. Cullum et al (2007) identifies four requirements:-Clinical experience, valid researched evidence, available resources and lastly but no less important the patient

Evidence based practice, “involves integrating the best available research evidence with professional expertise while also taking account of patient preferences the patients state setting and circumstance and health care resources” (Gerrish, K. Lathlean, J, 2015). As the health care profession constantly changes, then it is vital that all evidence based practice is kept up to date with current information and research, relating to nursing practice. Always assuring that the patients need are taken into consideration (Sackett et al, 1996).

The entire health industry is highly commercial and the face of the industry has changed and so has the requirements. Value creation today is mostly done by pharmacy benefit managers, doctors, nurses and the Physician Assistant--PA. These and health maintenance organizations are the new healthcare players. They are in need of modern tools to improve the medical cost management skills, and creating a competitive organizational culture. (Lopez, 7) The evidence-based practice which evolved in early 1990s was related to create organizational development including finding evidence for a specific clinical condition which later spread to become evidence-based practice as a part of management approach to service improvement. (Dunning, Delivering Better Health Care: What can go wrong when you are implementing evidence-based practice? Some lessons from the development process)

Evidence based practice and practice based evidence are a big part of a treatment process. These two can provide appropriate treatment that is needed to make advances in health care practices. Having enough evidence helps people determine whether to do something or not. To provide the best possible treatment for each patient you have to take information and see what will work best for each of your patients. Some will work and some will not work. Methodological issues can arise with in any type of research and some are more controversial than others. In the article “Practice Based Evidence: Back to the Future” (2011) the point of view was that research comes from evidence and that

Evidence based practice (EBP) is the utilisation of best available, contemporary research in the management of individual patient care (Sackett et al. 2000). Combined with the personal experience of the healthcare professional, EBP facilitates problem-solving that takes patient preferences and values into account (Melnyk and Fineout-Overholt 2005). The approach respects the patient as an individual and as a partner in the planning and receiving of care. EBP aims to reduce the use of ineffective healthcare interventions and encourage clinical decision-making that is based on modern credible evidence (Stevens 2013). Concisely, it aspires to achieve best outcomes for patients hence increasing the standard of care nurses provide to their

Majid,S.Foo,S.Luyt,B.Ahang,X.Theng,YL.Chang,YK.Mokhtar,IA.(2011) Adopting and evidence-based practice in clinical decision making: nurses’ perceptions, knowledge , and barriers. Journal of the Medical Library Association 99(3) PP229-236.

). An essential component of nurses’ knowledge and skills in delivering quality care is basing practice on information coming forth from the best available evidence termed ‘evidence-based practice’. However, accessing the latest research in itself does not constituteevidence-based practice. Appropriately using the knowledge from the information for the individual patient and individual situation is what marks the transition from evidence being simply information to being best practice. Using evidence based practice assists the delivery of person-centred care

Patient's decision-making is influenced by several factors. Patients may change their decisions, from accepting or refusing treatment depending on the available treatment options. The capacity of the individual to make informed medical decisions can differ as the patient's status changes cognitively, emotionally, and/or physically and as the proposed treatment interventions change. Treatment refusal is a common situation faced by clinicians. Patients do not usually refuse the medical advice if the advice is of good intention. When patients refuse an advice, it indicates some underlying reasons related to the patients or family, factors associated with the physician as well as social and organizational issues.

Evidence based practices are important to explore for various diseases so that their efficacy level can be determined and medical staff can be trained accordingly. Particularly speaking in the context of chronic diseases, evidence based practices are to be evaluated with the joint efforts of multiple healthcare institutions so that it can bring benefits to the overall healthcare industry.

Rousseau repeatedly refers the development in clinical and evidence based medicines and links it with evidence based management . Whereas, in the same article she says that clinical practices differs from management practices and both are imposed by different stakeholders with different entry requirement. Learmonth and Harding (2006) also put forward in their article that “Evidence based health care” guided approach to Evidence based management is somewhat imprudent. Raine (1998) has also characterized evidence-based practices as the current ‘ zeitgeist in health care ’ , not in management practices. Rousseau supports ‘transfer of research findings’ on the basis of ‘unique paradox’ only . She says in her article that unlike policing and education management is mainly private sector activity while Learmonth and Harding by citing number of literatures say that “In parallel with this development, evidence-based approaches are increasingly being commended for policy and management

“One of the strongest and most far-reaching current trends in health care is the application of evidence - based practice through the development